Millions are going online to the Affordable Care Act health care exchanges that opened up for business Tuesday morning. There's been talk about glitches and other logistical challenges, but what about beyond the initial phase of signing up? There are a variety of problems that could arise once newly insured Americans try to actually visit a doctor too. Primary care doctors are already in short supply and will be stretched even further when all the insurance policies are put to use.

And it's easy to see why. The child poverty rate in Camden is nearly 40 percent, and median household income is 58 percent below the New Jersey average rate. There are six times as many violent crimes in Camden than the state average. Camden is a challenging place to practice medicine.

The clinic helps over 1,400 patients each year and is in dire need of another doctor to share the workload. Dr. D'Ambola often stays late to see patients, whose needs vary wildly from diabetes and obesity to mental health problems. Overcrowded and understaffed, St. Luke's workers have to get creative about how they use their space, holding meetings in their cramped kitchen.

"What we really need is a new building," admits Dr. Lesly.

Dr. D'Ambola has worked at St. Luke's on Camden's State Street since 2000 and says she arrived well-prepared for life 'in the trenches.' She completed her training in an urban setting at St. Michael's Medical Center in Newark, NJ. And as Assistant Professor of Medicine at the University of Medicine and Dentistry of New Jersey, she makes sure her students get the same exposure to inner-city practice as she did.

"Camden is difficult, and it's dangerous," she tells me. "We had a lot of murders last year. Despite all the bad things you hear about Camden, a lot of good people live here."